An exemplary catheter can be provided which can include, for example, a first inflation arrangement configured, in operation, to substantially seal and/or anchor the catheter inside the bladder when inflated, a second inflation arrangement configured, in operation, to substantially float in urine when inflated, wherein the second arrangement can be located at a predetermined distance from the first inflation arrangement, and an aperture provided between the first inflation arrangement and the second inflation arrangement, where the first and second arrangements can cause the aperture to be (i) open when the second inflation arrangement can be located at a first position relative to the first inflation arrangement, and (ii) closed when the second inflation arrangement can be located at a second position relative to the first inflation arrangement, and where the second position can be different than the first position.
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1. A catheter comprising:
a first inflation arrangement configured, in operation, to substantially seal a bladder when inflated;
a second inflation arrangement configured, in operation, to substantially float in urine when inflated, wherein the second arrangement is located at a predetermined distance from the first inflation arrangement; and
an aperture provided between the first inflation arrangement and the second inflation arrangement, wherein at least one of the first and second arrangements cause the aperture to be (i) open when the second inflation arrangement is located at a first position relative to the first inflation arrangement, and (ii) closed when the second inflation arrangement is located at a second position relative to the first inflation arrangement, and wherein the second position is different than the first position.
2. The catheter of
3. The catheter of
4. The catheter of
5. The catheter of
6. The catheter of
7. The catheter of
8. The catheter of
9. The catheter of
10. The catheter of
11. The catheter of
12. The catheter of
13. The catheter of
14. The catheter of
15. The catheter of
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The present application relates to and claims priority from International Patent Application No. PCT/US2015/066845 filed Dec. 18, 2015 which published as International Publication No. WO 2016/100901 on Jun. 23, 2016 and from U.S. Patent Provisional Application No. 62/094,123, filed Dec. 19, 2014, the entire disclosures of which are incorporated herein by reference.
The present disclosure relates generally to a catheter, and more specifically, to exemplary embodiments of a urinary catheter configured to control bladder content volume, and methods for use thereof.
External beam radiation therapy to the pelvis is the standard of care for a variety of malignancies such as rectal, anal, uterine and prostate cancers. Radiation therapy applied to the pelvis attempts to deliver a cytotoxic radiation dose to the tumor and the areas at risk for tumor metastasis such as lymph nodes, while also limiting the dose to normal body structures so as not to damage the normal body structures. Different body organs have various tolerances to radiation. For example, the small bowel can be much more sensitive to radiation than the bladder. Radiation to the small bowel can result in side effects such as abdominal pain, vomiting, diarrhea, bowel obstruction, perforation and/or bleeding. Therefore, radiation therapy applied to pelvic malignancies is preferably delivered while the patient's bladder is full with urine in order to push the small bowel out of the radiation fields, and to decrease the volume of radiation received by the small bowel.
The computerized tomography (“CT”) simulation for planning of radiation therapy, and the delivery of radiation treatment fractions, should preferably be performed while the bladder is full with approximately the same amount of fluid in each session. However, currently there is no precise way to control the volume of urine in the bladder, and patients are usually instructed to urinate, drink a certain amount of water within specified time before radiation and be hopeful that they will have approximately the same amount of urine in their bladder at each treatment session. An ultrasound evaluation of the urine volume in the bladder can be performed before the treatment to quantify the urine the volume in the bladder, and if the urine volume is not at a specific preset level, the patient is instructed to wait, and drink water, and have the measurement of the urine repeated until the specified volume of urine is reached. However, this method does not allow for precise control of the volume of urine in the bladder.
Thus, it may be beneficial to provide an exemplary catheter which can control the volume of urine in the bladder, and that can overcome at least some of the deficiencies described herein above.
An exemplary catheter can be provided which can include, for example, a first inflation arrangement configured, in operation, to substantially seal and/or lock a catheter in the bladder when inflated, a second inflation arrangement configured, in operation, to substantially float in or on urine when inflated, where the second arrangement can be located at a predetermined distance from the first inflation arrangement. An aperture can be provided between the first inflation arrangement and the second inflation arrangement, where the first and second arrangements can cause the aperture to be (i) open when the second inflation arrangement can be located at a first position relative to the first inflation arrangement, and (ii) closed when the second inflation arrangement can be located at a second position relative to the first inflation arrangement, and where the second position can be different than the first position.
The first inflation arrangement and the second inflation arrangements can include balloons. The first inflation arrangement can include a liquid having a density substantially equal to or greater than the density of water, and the second inflation arrangement can include a liquid or gas having a density that can be less than the density of water, which can include oil, or air. At the first position, the second inflation arrangement can be positioned in a substantially parallel manner to the first inflation arrangement, and, at the second position, the second inflation arrangement can be positioned in a non-parallel manner to the first inflation arrangement. At the first position, the second inflation arrangement can be located at a first location relative to the first inflation arrangement, and, at the second position the second inflation arrangement can be located at a second location relative to the first inflation arrangement, the second location being different than the first location. The first location can be further away from the first inflation arrangement than the second location.
In some exemplary embodiments of the present disclosure, a hinge(s) can be located between the first inflation arrangement and the second inflation arrangement, which can be located substantially near the aperture. A spring(s) can be located between the first inflation arrangement and the second inflation arrangement. The first inflation arrangement can be further configured to anchor the catheter to the bladder. A mechanism can be configured to cause the aperture to remain open in the first position and the second position. A heating arrangement, which can be a radio frequency heating arrangement, can be configured to apply heat to the bladder.
A further exemplary embodiment can include a catheter, which can include, for example, an inflation arrangement configured to substantially seal a bladder when inflated, an aperture provided at a first distance from the inflation arrangement, and a junction connected to the inflation arrangement provided at a second distance from the inflation arrangement. A first portion can be connected to the junction. A first valve can be configured to selectively facilitate a flow of liquid through the first portion, and a second portion can be connected to the junction. A second valve can be configured to selectively facilitate the flow of the liquid through the second portion. The first valve can be a ball valve, and the second valve can be a check valve, which can include a spring. The second valve can be configured to facilitate the flow of liquid when the spring is compressed. The inflation arrangement can be further configured to anchor the catheter to the bladder. The junction can be a T-junction and/or a Y-junction. A heating arrangement, which can be a radio frequency heating arrangement, can be configured to apply heat to the bladder.
These and other objects, features and advantages of the exemplary embodiments of the present disclosure will become apparent upon reading the following detailed description of the exemplary embodiments of the present disclosure, when taken in conjunction with the appended claims.
Further objects, features and advantages of the present disclosure will become apparent from the following detailed description taken in conjunction with the accompanying Figures showing illustrative embodiments of the present disclosure, in which:
Throughout the drawings, the same reference numerals and characters, unless otherwise stated, are used to denote like features, elements, components or portions of the illustrated embodiments. Moreover, while the present disclosure will now be described in detail with reference to the figures, it is done so in connection with the illustrative embodiments and is not limited by the particular embodiments illustrated in the figures and the appended claims.
The exemplary apparatus, according to various exemplary embodiments of the present disclosure, described herein includes a urinary catheter with valve that can open once urine accumulates in the urinary bladder to a specific level. The exemplary catheter can include an indwelling urinary catheter with two, or more, balloons. The balloons can be inflated after catheter insertion, for example, when both are already resident in the urinary bladder. The first balloon can function as an anchor to the catheter inside the urinary bladder, and can be filled with a substance (e.g., a liquid, solid and/or gas) with a density equivalent to the density of water or higher. The second balloon can function as a float, and can be inflated with a substance having a density less than that of water (e.g., oil and/or air). The float (e.g., second) balloon can float on or in urine, and once the bladder fills with urine to a specific volume a valve can open, facilitating the drainage of urine. Once the urine volume decreases below a specific preset volume, the valve can close. This exemplary configuration can facilitate the bladder urine volume to remain within a specified tight range, ensuring or facilitating a continuous filling of the bladder, while hindering the bladder from overfilling. This can ensure or facilitate the urinary bladder to stay full, while keeping the patient safe from renal failure due to a bladder obstruction.
For example,
The floating balloon 130 can be filled with a substance having a density lower than that of urine or water (e.g., oil and/or air), after the insertion of the catheter 100 into the urinary bladder 135. The catheter can have multiple lumens (e.g., 3). A first lumen can be the urine drainage tube 105, a second lumen can be for inflation and deflation of the anchor balloon 110, and a third lumen can be provided for inflation and deflation of the floating balloon 130. The bladder volume control mechanism can be used continuously in its active form as shown in
As shown in
When the bladder is full, as shown in
As shown in
The exemplary catheter 400 can have multiple lumens (e.g., three), a first lumen can be the urine drainage tube 405, a second lumen can be provided for inflation and deflation of the anchor balloon 410, and a third lumen can be provided for inflation and deflation of the floating balloon 420. The bladder volume control mechanism can be used continuously in its active form, or can be used together with the exemplary activation mechanism and deactivation mechanism. Once the exemplary activation is in its “On” position, the sliding arm 430 position can be controlled by the floating balloon 420 location as described above. When the exemplary activation mechanism is in the “Off” mode, a stabilizing mechanism can maintain the sliding arm 430 in its maximal position out of the urine drainage tube, keeping the drainage hole 415 open regardless of the bladder volume, which can result in continuous full drainage of the bladder.
When the bladder is almost empty, as shown in
The exemplary catheter 500 can have multiple lumens (e.g., three). For example, a first lumen can be urine drainage tube 505, a second lumen can be for inflation and deflation of the anchor balloon 510, and a third lumen can be tube 535 for inflation and deflation of the floating balloon 520. An exemplary bladder volume control mechanism can be used continuously in its active form as shown in
An exemplary deactivation mechanism can include a spring 540 that can be continuously compressed regardless of the float balloon condition, which can result in a continuous opening of the drainage aperture 515, as shown in
A urine drainage tube 705 of the exemplary catheter 700 can drain the urinary bladder 720 through the urethra. An anchoring balloon 710 (e.g., for anchoring the catheter in the urinary bladder 720) can be inflated once the catheter can be in the urinary bladder 720. The part of the urine drainage tube 705 inside the urinary bladder 720 can be fully or mostly sealed except for a drainage hole 715 for draining urine from the urinary bladder 720 through the urine drainage tube 705. The drainage hole 715 can be continuously open. The urine drainage tube 705, once outside the body, can split into two tubes.
The first tube can be connected to a check valve 725, such as ball and/or a spring valve, that can automatically open when the urine pressure exceeds a specific preset limit, (see, e.g.,
The exemplary catheters described herein above can be used to treat patients with intra-vesical medications such as Bacillus Calmette-Guerin (“BCG”), chemotherapy such as Mitomycin C, Cisplatin, pegelated drugs and/or antibiotics. The concentration and the temperature of the medication inside the bladder can be maintaned within a specified target range by continuously filling and draining the bladder with the target material. Additionally, or alternatively, the concentration and the temperature of the medication inside the bladder can be kept within a specified target range by adding concentrated medication per each volume of urine drained so that the concentration of the medication in the bladder is kept constant and/or by combining the bladder filling mechanism with various suitable heating arrangements such as a radio frequency (“RF”) heating arrangement. (See, e.g., RF heating arrangement 140 from
The second tube can be controlled by a ball and socket valve 730, and can be opened and/or closed manually, for example, when in an open position, it can facilitate the urine to flow in the second tube regardless of the urine pressure. When the ball and socket 730 valve is in the closed position, urine cannot drain in the second tube, and urine drains only in the first (e.g., parallel) tube through the ball and spring check valve 725 when the pressure exceeds specific limit. This can result in the filling of the urinary bladder 720 as long as the specific pressure is not exceeded. Urine from either of the tubes can drain into the urine drainage tube connecting the catheter to the urine collecting bag 740. The exemplary urinary pressure check valve 725, can be or can include a ball and spring valve, and/or any check pressure valves used for ventriculo-peritoneal shunts, with the only difference being that the exemplary urinary valve can be adapted to the desired the urinary bladder pressures. In addition or alternatively, check valves, such as gravitational shunt valves, can be used to facilitate modified bladder drainage according to the patient position, and to facilitate tuning of the opening pressure to clinical needs and desired bladder filling. Unlike ventriculo-peritoneal shunts, the exemplary catheters described herein can contain a parallel channel with a ball and socket valve 730 that can actual shunt the check valve when bladder filling is not needed.
The exemplary urinary catheter, according to various exemplary embodiments of the present disclosure, can be used to control the urinary bladder urine volume, and can include a urine drainage tube, a valve mechanism that can open and close the urine drainage tube, an anchoring balloon filled with water, which can be inflated after inserting the catheter into the bladder in order to keep the catheter in place, and a second float balloon, filled with a substance having a density less than water (e.g., oil and/or air), and can be inflated after insertion of the catheter into the bladder. The float balloon can control the valve mechanism, and can open it when the bladder is full to a preset amount, and can close it when the bladder fullness is less than the preset amount.
The exemplary urinary catheter can be inserted through the urethra into the urinary bladder, with the valve which, when open, can facilitate the drainage of urine from the bladder, and when closed, can prevent drainage of urine from the bladder. The valve can be open only when the bladder is full to a specific amount, and can be closed when the volume of urine in the bladder can be less than specific amount. The valve can be controlled by an exemplary mechanical system that can include a hinge, and a balloon at the edge of the hinge that when inflated with air or oil, can function as a float. The valve can open when the balloon is fully afloat in the urine in the bladder, and can be closed when the float is not fully floating in the urine. The weight and/or position of the float balloon can be modulated so that the valve can open with a changing amount of urine (e.g., according to clinical needs).
The valve mechanism can be deactivated by a stabilizing mechanism, such that the valve can be kept open when the patients is out of the hospital, and the valve mechanism can be reactivated before a procedure that needs the bladder to be full (e.g., about 1-2 hours).
The exemplary urinary catheter can control urinary bladder volume. The exemplary catheter can have a urine drainage tube, an anchoring balloon filled with water which can be inflated after inserting the catheter into the bladder in order to keep the catheter in place. The portion of the drainage tube outside the body can be split into two tubes. The first tube can be connected to a check valve (e.g., a ball or a spring valve), that can automatically open when the urine pressure exceeds a specific preset limit, and can close if urine pressure is less than the specific limit. A second tube can be controlled by a ball and socket valve where the ball and socket valve can be opened and closed manually, and when in the open position, can facilitate urine to flow in the second tube regardless of the urine pressure. When the ball and socket valve is in a closed position, urine may not drain in the second tube, and urine may drain only in the first tube when the pressure exceeds the specific limit, resulting in filling of the urinary bladder as long as the specific pressure is not exceeded.
Each of the exemplary valves can be or include a gravitational valve that can facilitate modified bladder drainage according to the patient position. The valve can be at the catheter outlet, outside the body of the patient, and before the connection to the urine collection bag. The exemplary valve mechanism can be shunted by a parallel draining tube, where the shunting mechanism can be tuned to the open position when the bladder filling is not needed, and can be tuned to closed position when the bladder filling mechanism is needed, facilitating the urine to flow through the check valve once the pre-specified urine pressure can be achieved.
While the exemplary catheter has been described above for us with radiation oncology to fill the bladder, the exemplary catheter can also be used to treat patients with intra-vesical chemotherapy or medications. This can result in exposure of the bladder to the medication, while draining the bladder only as necessary
The foregoing merely illustrates the principles of the disclosure. Various modifications and alterations to the described embodiments will be apparent to those skilled in the art in view of the teachings herein. It will thus be appreciated that those skilled in the art will be able to devise numerous systems, arrangements, and procedures which, although not explicitly shown or described herein, embody the principles of the disclosure and can be thus within the spirit and scope of the disclosure. Various different exemplary embodiments can be used together with one another, as well as interchangeably therewith, as should be understood by those having ordinary skill in the art. In addition, certain terms used in the present disclosure, including the specification, drawings and claims thereof, can be used synonymously in certain instances, including, but not limited to, for example, data and information. It should be understood that, while these words, and/or other words that can be synonymous to one another, can be used synonymously herein, that there can be instances when such words can be intended to not be used synonymously. Further, to the extent that the prior art knowledge has not been explicitly incorporated by reference herein above, it is explicitly incorporated herein in its entirety. All publications referenced are incorporated herein by reference in their entireties.
Nasser, Nicola J., Zelefsky, Michael J.
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Mar 19 2015 | NASSER, NICOLA J | Memorial Sloan-Kettering Cancer Center | ASSIGNMENT OF ASSIGNORS INTEREST SEE DOCUMENT FOR DETAILS | 054846 | /0051 | |
Oct 14 2015 | ZELEFSKY, MICHAEL J | Memorial Sloan-Kettering Cancer Center | ASSIGNMENT OF ASSIGNORS INTEREST SEE DOCUMENT FOR DETAILS | 054846 | /0051 | |
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